EBCOG Part 1 Oncology – Day 4 EMQ

a.WLE

b.re-excision

c.Radiotherapy

d.WLE + unilateral SLN

e.WLE + bilateral SLN

f.WLE + unilateral IFL

g.WLE + bilateral IFL

h.Pelvic exenteration

i.Definitive chemotherapy

j.Multiple biopsies

k.Definitive chemoradiotherapy

l.Radical local excision with IFL.

choose the most appropriate treatment option for the scenarios given below. Each option may be used once, more than once or nor at all.

1.A 65 year old woman presented to gynecology clinic with severe vulval itching for past 1 year ,not responding to any treatment.On exam she was found to have lichen sclerosus & 3 areas about 0.5 cm in size each which looked suspicious.what is the most appropriate management for her?

2.70 year old lady with diagnosis of squamous cell carcinoma of vulva ,treated by WLE.Histopathology report shows the margins of the excised tissue have invasive cancer.What will you advise next?

3.65 years old lady presented to the clinic with vulval soreness.On exam she was found to have a 5 cm growth on labia minora & majora –right side & >1 cm form midline.Biopsy confirmed it to be invasive squamous cell carcinoma.CT of groins revealed suspicious lymph node involvement.

4.74 years old lady with severe vulval pain & itch & foul smelling discharge.On exam she was found to have a 5cm exophytic mass on right labia extending to urethra.Biopsy revelead it to be a squamous cell carcinoma.CT of abdomen ,pelvis & groin revealed –groin lymph node involvement & liver & pelvic metastasis.What is the most appropriate treatment for her?

5.50 years old lady who has undergone WLE of squamous cell carcinoma of vulva ,came for follow up & was found to have 0.5 cm growth,depth of invasion >1mm.